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!' <br />REGULAR (112) PERMIT ~^~~~~~•~•'•°"° <br />S APPLICATION FORM e.r'~..x`!~9'+~tt'""'` <br />This form contains two major parts: (1) General Operation Information artd (2) Exhibits <br />A-P: When you submit your application; be sure to include four signed copies of the <br />General Operation Information, four copies of Exhibits A-P, and as cTieck for the <br />application fee described under (4) below: To expedite processing, please pro.iy'de the ~3 ~4 , <br />information in the format and order described in this-form------------------~"'_-JU~_~~*~~-- <br />------------------------------------------------ - <br />GENERAL OPERATION INFORMATION <br />Type or print clearly; in the space provided, all information described below. <br />1. Applicant/Operator Name: Broderick & Gibbons, lnc. <br />2. Operation Name (Pit; mine or site name): STATE PIT <br />3. Application type: Regular (i12) Permit Operation. <br />4. Application Fee for Permitted Acreage* 1046 permitted <br />acres. <br />($50.00 + $15.00/acre, 1st: 50 acres; <br />$10.00/acre, 2nd. 50 acres; $5,00/acre, 3rd. 50 acres; <br />$1.00/acre, any additional acreage; maximum fee of <br />$2,000,00},* <br />• Note permitted acreage and application fee and $2000.00 <br />attach a check for this amount when you file: application fee. <br />5. Substances} to be mined (e: g:; gold/sliver/gravel): gravel <br />6, Owners(s) of Substance to be Mined <br /> (check applicable box(s}): ` Private x State - Federal _ Indian <br />7. Owner(s) of Record of Affected Land <br /> (check applicable box(s}): - Private x State , Federal _ Indian <br />8. Type of Mining Operation <br /> (check applicable box(s)): x Surface _ Underground _ In-situ <br />9, Location Information. The center of the area where the majority of mining will <br /> occur lies in: <br />COUNTY: PUEBLO <br />PRINCIPLE c ec one ~ 6th (Colorado) 10th (New Mexico) Ute <br />TOWNSHIP (write number and check direction): T 21 North x South <br />RANGE (write number and check direction): R 63 ` East x West <br />SECTION (write number): S 21, 22, 28 <br />QUARTER SECTION (check one): N~ _ NW _ SE _ SW <br />QUARTER/QUARTER SECTION (check one): ` NE _ NW _ SE _ SW <br />GENERAL DESCRIPTION: <br />• (miles and direction 2 miles south of Vineland. 10 miles <br />from nearest town and <br />SE of Pueblo. 4800' <br />approximate elevation) _ _ _ _ _ _ _ <br />* If the operator is a unit of State or county government, an application fee is not <br />required. A fraction of an acre must be counted as one acre for fee calculation. <br />